Nurse Volunteers Step Up to Fill Pandemic-Related Staffing Gaps

Roxanne Nelson, RN, BSN


October 29, 2021

After putting in a long day as charge nurse of the clinic, Nancy Colobong Smith, MN, ARNP, was surprised to get a text at 9:30 PM asking if she could return to the clinic and volunteer to administer COVID vaccines. She had only been home for about 2 hours, but it seemed that there was a vaccine emergency.

A refrigerator had malfunctioned at a Seattle hospital, which meant that the Moderna vaccines stored inside needed to be used quickly or they would have to be thrown away within a few hours. Health officials reached out to other local hospital systems, letting them know that there were 1600 doses of vaccine that needed to be administered within the next 12 hours.

"It was January 2021, and the vaccine was a rare commodity with very limited supply," said Smith, a clinical nurse specialist in renal, dialysis, and transplant at the University of Washington Medical Center. "It was not available at the local drug store for everyone over the age of 12. When the announcement went out over social media and the evening news, people came in droves despite the late hour and the cold," she recalled.

"The line went around the front of the hospital and toward the nearby university buildings," she said.

Smith and other nurses administered about 400 vaccine doses between 11 PM and 2 AM. The volunteers were nurses who agreed to stay past their shift, those who came in from home, as well as volunteers from the local fire department.

Need for Volunteers

Most of the nursing-related headlines recently have centered around the acute staffing shortages that facilities around the country are grappling with. While nursing shortages existed long before the first case of COVID-19 arose in the US, the pandemic has exacerbated the problem. However, in addition to filling beds to capacity without the staff to care for the burgeoning number of patients, the pandemic also created a need for support personnel.

Both federal and state agencies have issued calls for volunteers, including local departments of health and the Medical Reserve Corps (MRC), a national network of more than 200,000 volunteers that is organized locally. In many cases, nurses and other healthcare workers have volunteered and doubled up on various COVID-related tasks in their own workplace.

By April 2020, soon after COVID took hold of the United States, at least 82,000 healthcare workers had volunteered in New York. Respondents who answered the state's call for a reserve force of medical workers included people who were recent retirees, healthcare professionals who were able to take time off from their regular jobs, and people between jobs. Hospitals and state regulators were then tasked with the job of vetting people and deciding how to deploy them.

Who Is Volunteering?

As the first vaccines became available to the public, personnel were needed to administer them. At the end of December 2020, and as they were struggling to keep up with the demand for coronavirus vaccines, a number of state health departments and other organizations began asking medical and nursing students, and even firefighters, to help administer the injections to free up healthcare workers to care for patients.

More than 630 of Indiana University's medical and nursing students signed up as volunteers as soon as the vaccines became available in the state. However, as state licensing laws vary, not all medical and nursing students are permitted to administer vaccines without the supervision of a fully licensed professional. At that time, at least two states, Massachusetts and New York, changed their laws to allow more flexibility for administering vaccines.

Lisa Campbell DNP, RN, is professor and director of the Post-Master's Doctor of Nursing Practice Program at Texas Tech University Health Sciences Center School of Nursing. The board-certified advanced public health nurse volunteered through the Texas MRC to give vaccinations. "This was at one of the mass-vaccination clinics that were set up," she said. "We had a lot of volunteers taking temperatures, runners bringing us the vaccines, pharmacists reconstituting them, and nurses drawing them up."

Campbell explained that she started volunteering in January and continued through the summer, at which point the vaccine became readily available. She said that although she wasn't being compensated, other nurses were. "It was a mix," she said. "Some were being paid to give the vaccines and others weren't."

Many of the volunteers who stepped up to the plate had already retired from "active duty" and were no longer working in any aspect of healthcare. For Semmes Burns, RN, a former PICU nurse who had left nursing while pregnant with her first child, it was a way of getting back into healthcare. "I always missed it, as I feel like nursing was probably my true calling in life," she said. "Over the years, I'd kept my license inactive as it didn't make sense to keep up with CEUs and such, and if I wasn't going to go back to working full-time, the hurdles to reactivating my license for an inpatient job seemed too great."

However, when COVID hit, Burns was reading the news and saw the call for nurses to help administer COVID tests, which at the time had to be done by a nurse, and later to vaccinate at mass-vaccination sites. "I got involved in the late spring of 2020 when I read online that Texas would let me reinstate my license in order to help with COVID response," she said. "So I reactivated my license and reached out to the Harris County Medical Reserve Corps asking if I could volunteer with them."

Long active in various volunteer activities, Burns felt that not only was volunteering "in her blood," but that this would allow her an opportunity to put her skills to use in a very tangible way and meet a real need that had become apparent in her community. Burns was also surprised to find out that most of the nurses that were working at the sites were paid agency staff, which she wasn't aware of before she began. She started volunteering at the testing sites through the summer, usually once a week.

When the MRC began to prepare for mass-vaccination sites, Burns jumped at the opportunity to help there as well. At first, only first responders were being vaccinated, according to early guidance. The turnout wasn't as high as expected, which was a "little disheartening," she said.

As the winter moved into spring, they continued to vaccinate first responders and then those who had preexisting conditions or who were over the age of 65 years, and it was then that Burns began to feel real satisfaction. "I really felt like my efforts were making a difference," she said. "So many people came through and cried tears of joy or would cheer when they got their first dose."

Another retired nurse who answered the call to help out was Jeanne J. Kiefner RN, MEd. A retired school nurse from New Jersey who is in her 80s, she also volunteered to help with vaccinations. "I am a widow who lives alone but have much interest in the school nurses' association, and so many of my friends are working and still challenging me to do lots of projects," she said.

Kiefner administered the Moderna vaccine at the Rowan University School of Osteopathic Medicine from January through mid-June, at least two or three days a week. "Because I am so accustomed to being involved with nursing, teaching, helping, writing, ... when the pandemic affected so many, I wanted something to help me interact with the community," she said. "I wanted to help people in need of support and education."

Mix of Volunteers

But while many volunteers are donating their time and expertise, many are also being paid, working beyond their regular job but receiving compensation. Hospital volunteers in New York were paid, for example, but in the state of Washington, it depended on where the volunteer worked whether they were paid. Retired nurses who staff free clinics do not routinely receive compensation, although those volunteering at hospitals are generally paid.

Aisha Allen, DNP, CRNA, who lives in the Raleigh-Durham-Chapel Hill area of North Carolina, has pitched in beyond her regular duties. "I was placed in various roles throughout the hospital," Allen said. "My skills were utilized to not only administer anesthesia and intubate sick patients, but also to administer vaccines and run COVID clinics, among other tasks.

"I volunteered [for COVID tasks] because there was a shortage of nurses available to perform jobs that only registered nurses could," she added. 

Smith also found that she was doing a mix of her regular work and volunteer work, all at her usual place of employment. "Since the beginning of the pandemic it is challenging for me to differentiate what is 'volunteer' and what is 'work' because so much of the day-to-day has been evolving and changing," she explained. "As the pandemic started and clinic appointments and surgeries were limited, I volunteered in various roles to support staff."

One volunteer role was to teach staff how to use personal protective equipment (PPE). "A PPE monitor was assigned to help staff make sure that they had their PPE on correctly going into [COVID] rooms and [being] careful when taking off their PPE as they leave rooms," Smith said. "There was a checklist that was being updated frequently as the supplies that were available seemed to be changing daily. It was an exercise on how to think on your feet and apply the best evidence we had at the time to keep our staff and patients safe."

Smith also learned how to be an N95 fit tester, as N95 masks must fit correctly in order to be effective. "It was an uncertain time, and any task to care [for] and protect our people was taken on gladly," she said.

Travel nurses could also be considered volunteers. Their numbers soared as the pandemic worsened. Hospitals in hard-hit cities such as New York relied heavily on travel nurses to fill staffing gaps, which were already well stretched before the pandemic. In 2018, data from the National Sample Survey of Registered Nurses found that an estimated 31,000 travel nurses were working around the United States. In November 2020, with hospitals overwhelmed and in dire need of nurses, there were at least 50,000 travel nurses working at various locations.

The Need Continues

The need for volunteers continues as the pandemic evolves and new issues arise, such as surges in cases despite high vaccination rates. For example, the Washington Department of Health recently issued a call for licensed healthcare providers — those who are not practicing currently and those who retired recently — to consider volunteering at hospitals that are currently facing staffing shortages. The surge in Washington cases occurred despite having a vaccination rate at press time of slightly more than 70% statewide.

"Even when it snowed a foot in February, which is unusual in this part of the Pacific Northwest, and I was asked to open the vaccine clinic because the other charge nurse could not get out of their driveway, I was happily greeted by other volunteers," Smith said. "Some volunteers had walked a few miles in the snow at 6 in the morning so we could open the vaccine clinic.

"All day, I was surprised by both the determination and tenacity of the volunteers and vaccine recipients who made their way slowly but surely to the hospital," she continued. "A little snow was not going to stop our community from giving or receiving vaccine doses."


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